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Asthma research study

What is the primary objective of this study?

Cough is a common, disruptive and at times disabling symptom which often prompts patients to
seek medical attention. Determining the cause(s) of chronic cough can be challenging, and
costly. Asthma and other airway disorders are among the most common causes of chronic cough;
and cough can be the sole symptom of asthma. Little is known about why some patients with
asthma primarily cough and do not develop the other symptoms of asthma such as shortness of
breath or wheeze. Improved understanding of the reasons for these different manifestations
may lead to new and more effective treatment strategies. We have notices differences in
pressure measurements inside the chest in patients who mostly cough during induced
bronchoconstriction, which might be part of the explanation for varying symptoms. This study
will compare lung mechanical responses during methacholine and mannitol-induced induced
airway narrowing between typical asthma, cough variant asthma (CVA) and an airway
inflammatory disorder that is not asthma.The purpose of this research is to explore the
pathophysiology and sensory-mechanics of cough in individuals with asthma, CVA and
methacholine-induced cough but normal airway sensitivity using mannitol and high-dose
methacholine bronchoprovocation testing.

Who is eligible to participate?

Inclusion Criteria:
1. Subjects with asthma or suspected CVA who have previously participated in or who have
expressed interest in participating in studies will be invited to participate in the
study. Previous treatment with inhaled or systemic corticosteroids is not an exclusion
criterion, but medication use will be recorded and examined in the analysis.
Exclusion Criteria:
1. An exacerbation necessitating any alteration in medication, emergency department visit
or hospitalizations within the previous 4 weeks;
2. Inability to perform acceptable quality spirometry;
3. Medical contraindications to methacholine challenge testing 35, including:
1. Severe airflow limitation (FEV1 <50% predicted or <1.0 L);
2. Heart attack or stroke in last 3 months;
3. Uncontrolled hypertension, systolic BP > 200 or diastolic BP > 100;
4. Known aortic aneurysm;
5. Moderate airflow limitation < 60% predicted or <1.5 L);
6. Inability to perform acceptable quality spirometry;
7. Current use of cholinesterase inhibitor medication (for myasthenia gravis); and
8. Pregnant or nursing mothers.
4. Smoking history in excess of 10 pack years;
5. Medical contraindications to mannitol challenge testing, including:
1. Aortic or cerebral aneurysm;
2. Uncontrolled hypertension; and
3. Myocardial infarction or a cerebral vascular accident in the previous six
months).
6. Women who are pregnant or breastfeeding because the effects of a possible
hyperresponsiveness reaction to mannitol in mothers and/or fetuses are unknown and
many compounds are excreted in human milk therefore caution should be taken.

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Discuss Cough

If you think you may have a medical emergency, call your doctor or 911 immediately.

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